中华口腔医学杂志最新文献

Pulpitis is an inflammatory response of the pulp tissue triggered by bacterial infection or mechanical trauma. Current diagnostic criteria classify it into two categories: reversible pulpitis and irreversible pulpitis. Wolters et al. proposed a four-level classification of pulpitis based on clinical symptoms, establishing a guiding framework for minimally invasive endodontics. With the development of precision medicine and molecular biological diagnostic techniques, biomarker detection has emerged as a quantitative tool for determining endodontic status. Diagnostic techniques that integrate multimodal information such as pain intensity assessment, endodontic diagnostic testing and biomarker detection can break through the limitations of traditional or single diagnostic methods, which not only providing clinicians with more scientific and comprehensive ideas for endodontic status assessment and treatment decision options, but also promoting the transition to precision medicine for endodontic diagnosis.

The global aging population has intensified the incidence of degenerative bone diseases and the therapeutic demand for traumatic bone injuries, thereby making bone regenerative medicine a research focus. There is a close connection and interaction between the skeletal system and the nervous system, and innervation plays an indispensable regulatory role in the process of bone regeneration: the sympathetic nervous system exerts a negative regulatory effect during bone regeneration, while the parasympathetic nervous system plays a positive regulatory role in this process. Nerve fibers within bones are distributed alongside blood vessels, with their density decreasing from the periosteum to the cancellous bone. Nerve signals regulate bone regeneration either by directly acting on target cell receptors or indirectly modulating the metabolism of the local microenvironment (such as the levels of inflammatory factors and the supply of nutrients). A variety of neuropeptides (e.g., calcitonin gene-related peptide, substance P, neuropeptide Y, vasoactive intestinal peptide, etc.) play a crucial role in bone tissue, constructing a "neuro-osseous" regulatory axis, which in turn regulates the osteoblast-osteoclast balance, angiogenesis, and the homeostasis of the local microenvironment. This review focuses on the neural regulatory mechanisms in bone regeneration, with an emphasis on sorting out the functions of key neuropeptides and related neurotransmitters. Neuropeptides are the core mediators of neuro-osseous interaction; however, the interaction network among neuropeptides remains to be further clarified, which requires the application of advanced in vitro models such as three-dimensional bioprinted bone models and organoid technology, as well as cutting-edge techniques like single-cell sequencing for analysis. In the future, the integration of neural regulation strategies with traditional bone regeneration technologies, along with the expansion into interdisciplinary fields such as neuro-vascular and neuro-muscular fields, is expected to provide new directions for the treatment of bone defects and large maxillofacial tissue defects, and promote the transformation of regenerative medicine from prosthetic treatment to functional and neurotized tissue regeneration.

Guided bone regeneration (GBR) has been widely used in the repair and reconstruction of alveolar bone defects. However, conventional GBR techniques often fail to achieve the desired bone augmentation for severe bone defects (diameter≥5 mm). To address this limitation, several innovative GBR-based approaches, such as the tenting and sausage techniques have been developed, achieving varying degrees of clinical success. Nonetheless, these methods still face considerable challenges, including secondary trauma from autogenous bone harvesting, high technical sensitivity, and limited scalability. In response, our team proposed a novel treatment concept centered on the principle of "stability-core", and developed a new therapeutic strategy that avoids the use of autogenous bone. This strategy involves the development of a new series of tent-peg medical devices and the introduction of the pouch technique, which has been successfully applied in clinical practice. This case report presents the successful use of the pouch technique for vertical ridge augmentation in the maxillary posterior region. At 8-month follow-up, substantial vertical bone gain and restoration of the alveolar ridge contour were achieved. Implant placement and prosthetic rehabilitation were completed with satisfactory functional recovery. The patient reported a positive treatment experience. This technique offers a promising and practical solution for alveolar bone reconstruction.

Pulpitis is an inflammatory response of dental pulp tissue triggered by external stimuli such as bacterial infection, mechanical trauma, and iatrogenic injury. Accurate diagnosis of pulpitis is essential for the success of minimally invasive endodontic treatments. However, the current diagnostic framework lacks objective indicators capable of precisely assessing the severity of pulp inflammation. Recent studies have revealed that biomarkers such as matrix metalloproteinases, cytokines, chemokines, non-coding RNAs, growth factors, and signaling molecules are closely associated with the degree of pulp inflammation. These findings suggested that biomarker-based molecular diagnostics held significant promise for advancing precision and minimally invasive approaches in endodontics. This review systematically discusses the current research progress, challenges, and future directions of biomarkers in the diagnosis and treatment of pulpitis.

Cleidocranial dysplasia, a rare genetic disorder primarily caused by Runt-related transcription factor 2 (RUNX2) heterozygous mutation, serves as a representative model for investigating regulatory mechanisms of RUNX2 in bone remodeling and tooth eruption. As a master transcription factor governing mineralized tissue development, RUNX2 orchestrates bone remodeling and tooth eruption through diverse regulatory networks. It drives alveolar bone formation via transcriptional activation, integration of multiple signaling cascades, and epigenetic modifications, thereby generating the biomechanical force for tooth eruption. Concurrently, RUNX2 promotes osteoblastic secretion of osteoclastogenic factors and directly regulates osteoclast precursor differentiation, facilitating bone resorption at the coronal aspect of dental follicles to estavlish the eruption pathway. Furthermore, RUNX2 modulates eruption progression by participating in stress-induced biological signal transduction within dental follicle cells (DFCs), remodeling the DFCs microenvironment, and regulating DFCs senescence. RUNX2 also influences root development via the NOTUM-Wnt axis, providing auxiliary biomechanical conditions conducive to eruption. This review systematically delineates the pivotal role of RUNX2 in coordinating bone remodeling and tooth eruption. Future studies should leverage organoid models and multi-omics technologies to further elucidate the spatiotemporal regulatory networks of RUNX2, potentially advancing precision diagnostics and therapeutics for rare skeletal-dental developmental disorders.

Pulpitis is a prevalent inflammatory disease in dentistry, and root canal therapy remains the primary clinical treatment for it. However, pulp removal leads to reduced tooth fracture resistance and complications such as secondary infection and tooth fracture. As a potential alternative, vital pulp therapy (VPT) relies on precise assessment of pulp status; yet current clinical diagnostic methods lack specificity. The establishment of appropriate animal models for pulpitis is crucial for investigating its pathogenesis, developing specific diagnostic biomarkers, and optimizing VPT strategies. This review systematically summarizes experimental animals selection based on anatomical compatibility and pathological similarity, as well as model construction methods and multimodal evaluation systems for pulpitis animal models, aiming to provide insights for related researches.

Objective: To analysis of the latent profiles and influencing factors of body image in patients with postoperative oral cancer. Methods: From July 2024 to March 2025, a total of 332 patients with primary oral cancer confirmed by pathology, aged ≥18 years, and undergoing oral cancer surgery at Hunan Cancer Hospital were selected using simple random sampling and cluster sampling. Among them, 25 were female and 307 were male. The body image scale and the Rosenberg self-esteem scale were used to investigate the patients. The main indicators included the total scale scores and scores on various dimensions of body image, such as appearance evaluation and health focus, with particular attention to satisfaction with facial appearance and oral function.The correlation between self-esteem and body image was analyzed, and differences in scores were compared based on gender, age, self-esteem level, and surgical procedure. Results: Among the 332 patients, 93.4% (310/332) were married, and 6.6% (22/332) were unmarried, divorced, or widowed. A total of 84.3% (280/332) underwent flap transplantation surgery, while 15.7% (52/332) did not. The body image distress in the 332 patients could be categorized into a body image adaptation group [80.12% (266/332)] and a body image disorder group [19.88% (66/332)]. Unmarried/divorced/widowed status (P=0.020), undergoing flap transplantation (P=0.006), and self-esteem level (P<0.001) were identified as influencing factors for postoperative body image disorder in oral cancer patients. Conclusions: Given the varying levels of body image concerns among oral cancer patients, healthcare providers can implement targeted, personalized nursing interventions based on their distinct categories and influencing factors.

To address the problem of data silos in dental specialties caused by equipment heterogeneity, this study developed an Intelligent Internet of Things (IoT)-enabled dental chair platform (hereinafter referred to as the intelligent platform) based on the concept of medical-engineering integration. The platform adopts a three-tier chair-domain interconnection architecture: the bottom tier integrates multi-source sensors and standardized interfaces for automated data acquisition and linkage with hospital information systems; the middle tier provides clinic-level management and remote teaching collaboration; and the top tier employs a blockchain-based secure cloud database for resource allocation and data management. Clinical validation at The Affiliated Stomatological Hospital of Nanjing Medical University demonstrated that, compared with a control group from the same period in 2023, the trial group achieved a 38.0% increase in average daily patient visits (80.6±6.8 vs. 58.4±5.2, t=15.16, P<0.001), a 24.6% reduction in average treatment time [(36.1±6.3) min vs. (47.9±8.5) min, t=7.72, P<0.001], a 39.2% reduction in waiting time [23.3 (16.5, 30.1) min vs. 38.3 (28.3, 48.3) min, U=32.00, P<0.001], a 30.4% reduction in equipment idle rate [8.7% (5.1%, 12.3%) vs. 12.5% (7.4%, 17.6%), U=251.00, P=0.003], and an increase in patient satisfaction from 88.2% (1 519/1 723) to 94.3% (2 186/2 318) (t=7.26, P<0.001). User research confirmed that the functions most favored by clinicians and patients were "dental chair parameter updating and clinical data integration" [74.7% (80/107)] and "chairside display of diagnostic images" [76.8% (119/155)], respectively. Looking forward, the intelligent platform has the potential to integrate artificial intelligence-assisted diagnosis and 5G-enabled multicenter collaboration to further expand its clinical applications and accelerate the digital transformation of dental healthcare.